Cancer is mean, just plain mean. Just like a bully, really! It sneaks up on you when you least expect it, it intimidates you, makes you feel afraid, uncomfortable, hurt, and, strips you of your confidence.

Once affected by cancer, no matter how successful the treatment, some still struggle with changes in themselves that neither medications nor therapy seem to overcome. The changes I am talking about are the cognitive ones, including thought processes and intellectual functions such as memory, problem solving, organization, planning, and goal setting.

Cognitive disruption following cancer diagnosis and/or treatment can occur in as many as 75% of patients. Those affected describe a loss in sharpness that is both frustrating and life altering. Health care professionals and scientists are just beginning to try to unravel why this happens, even though cancer patients themselves have been talking about it for years. The symptoms of “brain fog”, “chemo fog” or “chemo brain” include difficulties with memory, organization, multi- tasking and language. These kinds of changes can have an enormous impact on a person's ability to successfully function from day-to-day, and often continue long after the cancer has been treated.

Although we may not know the exact cause or combination of causes which lead to “brain fog”, we can certainly focus on how to remedy the situation. Cognitive enhancement programs teach people (either one-on-one or in small groups), through education and self-awareness, and trial-and-error, how to use new techniques and practice old techniques in order to enhance current cognitive status. Under the leadership of someone trained in brain-behaviour relationships, participants are taught to identify specific changes in cognition resulting from the cancer or cancer treatment and then learn methods, strategies and mechanisms to compensate. Successful cognitive enhancement has resulted in even minor treatment effects having an enormous positive impact on the lives of individuals affected.

Just as the physical symptoms and changes caused by cancer and cancer treatment vary from person to person, so do the cognitive changes. While one person may think a little slower, another may remember a little less, and others might get a little muddled when they do more than one thing at a time. So how does one know if their cognitive changes are normal or not? Start logging the incidents. When you review your ‘incident list’ ask yourself, is this normal or to be expected given the diagnosis and treatment? How does this differ to my previous levels of functioning? Make a conscious effort to reduce your blunders and monitor changes over time. Ask yourself if your mistakes are increasing in frequency and severity. Compare notes with others and openly communicate your changes and concerns with peers, family members and your health professional. There are many different causes for cognitive change!

Don’t let cancer, get the best of you. Fight the bully - play a proactive role in your cognition. Stay mentally and physically active. Learn and practice strategies and techniques for cognitive enhancement. Talk about the changes, don’t hide them. Take the “fog” out of the cancer experience and help yourself think more clearly!